坎地沙坦脂联合地黄叶总苷治疗早期糖尿病肾病疗效观察

Effect of integrated candesartan cilexetil tablets and acteoside capsules on microalbuminuria in patients with early diabetic nephropathy

目的观察坎地沙坦脂联合地黄叶总苷治疗早期糖尿病肾病的疗效。方法 56例早期糖尿病肾病患者随机分为两组,每组28例,单药组口服坎地沙坦脂片(商品名:维尔亚,4 mg/粒,1粒/次,1次/d),联合组在口服坎地沙坦脂片基础上联合地黄叶总苷胶囊(0.2 g/粒,2粒/次,2次/d)。治疗前后测定血压、空腹血糖、餐后2 h血糖、血清尿素氮(BUN)、肌酐(Scr)、血清胱抑素C(Cys-C)及尿微量白蛋白(UMA)。结果受试患者的血压、血糖和肾功能在治疗前,两组差异没有统计学意义,组内治疗前后比较也无统计学差异。但治疗后两组的Cys-C、UMA较治疗前均有降低,且有统计学意义(P<0.01);而且联合组治疗后变化更加明显,Cys-C下降为(0.93±0.65)mg/L,UMA下降为(62.5±6.4)μg/min,与单药组治疗后相比,差异有统计学意义(P<0.01)。结论坎地沙坦脂片联合地黄叶总苷对早期糖尿病肾病患者的血压、血糖和肾功能影响不大,但能明显降低UMA及Cys-C,从而延缓临床蛋白尿出现,起到护肾作用。

Objective To study the effect of integrated candesartan cilexetil tablets and acteoside capsules on microalbuminuria in patients with early diabetic nephropathy. Methods Fifty-six patients with early diabetic nephropathy were recruited and randomly divided into two groups, the single group and the integrated group. In the single group, 28 cases were treated with candesartan cilexetil tablets （4 mg·po·qd ）;in the integrated group,28 cases were treated with integrated candesartan cilexetil tablets（4 mg·po·bid） and acteoside capsules （0.4 g·po·bid）. BP（blood pressure）, FBG（fasting blood glucose）,2hFBG（2-hour postprandial blood glucose）, Bun,Scr, SCys-C and UMA were examined before and after treatment.Results There was no statistically significant difference between the two groups before treatment. After treatment, Cys-C and UMA were lower than that before treatment in both groups （P〈0.01）, and were remarkably reduced in the integrated group contrasted with the single group （P〈0.01）. Conclusions Integrated candesartan cilexetil tablets and acteoside capsules have no remarkable influence in BP, BG, Bun and Scr, but efficiently decrease the SCys-C and UMA in patients with early diabetic nephropathy.So the onset of clinical proteinuria can be delayed and the renal function can be protected.